After playing 50 hours of Skyrim I decided to do a fresh install of this. I must have done something right this time because I'm getting a better framerate. I decided to select a bit less on the texture packs (the roads look like MW roads again and the foliage is not drastically changed) and I dropped the Screen Space Ambient Occlusion (SSAO) shader and went with 2x AA, 4x AF. I still have godrays, HDR and water effects.